Provider Demographics
NPI:1225216021
Name:MANN, CHRISTINA MARIE (PHD, CRC, NCC, BCBA)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:MARIE
Last Name:MANN
Suffix:
Gender:F
Credentials:PHD, CRC, NCC, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5011
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28687-5011
Mailing Address - Country:US
Mailing Address - Phone:704-780-4235
Mailing Address - Fax:
Practice Address - Street 1:1318 E BROAD ST
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-5422
Practice Address - Country:US
Practice Address - Phone:704-780-4235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7237101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health